Objective Primary headache disorders are one of the most common pain conditions. Nutritional habits in children and adolescents with different headache types are limited. The aim of this study is to evaluate if breastfeeding, trough milk composition and its psychological characteristics, has a protective effect on development of headache.

Materials and Methods Two groups of subjects, 6–18 years old, were enrolled: 155 with recurrent primary headache, diagnosed according to ICHD-II criteria (cases); 161 without recurrent primary headache, recruited at school (healthy controls; HC). A questionnaire with four sections was administered to all children to evaluate status of the family, data on infant nutrition habits, presence of sleep disorders, recurrent abdominal pain, allergies, motion sickness and malocclusion.

Results 45.2% of cases were affected by migraine without aura, 17.4% by tension-type headache and 16.1% by migraine with aura. The onset of symptoms occurred at a mean age of 8.9 years (2.8 SD). 61% of cases versus 95% of HC reported breastfeeding habits (p<0.0005). 19% of cases versus 46% of HC reported breastfeeding duration more than 6 months (p<0.0005). Cases have more nutritional disorders than HC: body mass index >90° and >95° centile was more frequent for cases.

Discussion Our study shows a strong negative association, duration related, between recurrent primary headache and breastfeeding. To our knowledge this is the first study on this association.